Since the CPJ Respiratory Supplement went to press, there have been postmarketing reports of suicidal thoughts and erratic and/or aggressive behaviour, as well as new-onset depression, suicidal ideation, and emotion/behavioural changes in patients within days to weeks after initiating varenicline.1 In addition, some patients experienced drowsiness that affected their ability to drive. To date, we have not had any patients at our pharmacy report these effects, but I now counsel new patients regarding these possibilities, balancing them against the risk of continued smoking.
